Systematic Reviews
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Oct 15, 2020; 11(10): 459-467
Published online Oct 15, 2020. doi: 10.4239/wjd.v11.i10.459
Impact of technology use in type 2 diabetes distress: A systematic review
Patricia Vieira, Renata Kobayasi, Filomena Pereira, Isabella Martins Zaia, Sandra Umeda Sasaki
Patricia Vieira, Department of Health, Iron Saúde, Alcabideche 2649-517, Portugal
Renata Kobayasi, Department of Internal Medicine, University of Sao Paulo, Sao Paulo 05410-020, Brazil
Filomena Pereira, School of Psychology and Science of Education, University of Porto, Porto 4200-465, Portugal
Isabella Martins Zaia, Sandra Umeda Sasaki, Medical School UNICID, Sao Paulo 03071-000, Brazil
Author contributions: Sasaki S and Vieira P designed the study, performed the research and analyzed the data; Pereira F, Zaia I and Kobayasi R reviewed the paper; All authors read and approved the final manuscript.
Conflict-of-interest statement: All the authors declare that they have no competing interests.
PRISMA 2009 Checklist statement: The guidelines of the PRISMA 2009 statement have been adopted.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Sandra Umeda Sasaki, MD, PhD, Medical Assistant, Professor, Research Scientist, Surgeon, Medical School UNICID, Cesario Galero 488 Street Tauapé, Sao Paulo 03071-000, Brazil.
Received: April 24, 2020
Peer-review started: April 24, 2020
First decision: June 15, 2020
Revised: July 8, 2020
Accepted: August 31, 2020
Article in press: August 31, 2020
Published online: October 15, 2020

Diabetes distress is an important factor in treatment outcomes and results in poor behavioral and biological consequences. Technology has been used in management programs of diabetes to improve communication between patients and health care providers and to promote education about the disease and its psychological aspects, which can impact the self-efficacy of the programs. However, the true impact of technological approaches on the management of type 2 diabetes distress remains controversial.


To investigate the effectiveness of technology interventions on the management of type 2 diabetes distress.


Studies published from 2014 to 2019 were searched in five databases: MEDLINE, PubMed, Library and Information Science Source, Academic Search Ultimate and PsycINFO. The Boolean logic search terms were: (1) T2Diabetes; (2) diabetes distress; and (3) technology OR mobile OR phone OR application OR web. We also systematically searched the reference lists of the included studies and relevant reviews. Randomized controlled trials with technology interventions, type 2 diabetes patients and diabetes distress as the outcome were selected. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was followed.


Of the 88 studies selected, nine full articles met the inclusion criteria and were subjected to final careful review. On the JADAD scale, one article was classified as having poor quality and eight as having good quality. Six out of nine articles showed that technology interventions had a positive impact on diabetes distress scale scores when compared with the initial data. Among the six articles, five showed a greater reduction in the diabetes distress scores from control interventions. Web-based interventions had good results when users received personalized feedback and routine caregiver support and attention.


Technology interventions can contribute positively to the management of type 2 diabetes distress, especially with a tailored approach in conjunction with caregiver interaction with patients.

Keywords: Technology, Type 2 diabetes, Diabetes distress, Healthcare, Systematic review

Core Tip: Technology interventions can impact the reduction of diabetes distress and improve the outcome and quality of life of patients with type 2 diabetes mellitus.